Mood Disorders



Mood Disorders

A. Mood Episodes

1. Major Depressive Episode (video)

2. Manic Episode (video)

3. Hypomanic episode

4. Mixed Episode

B. Mood Disorders

1. Major Depressive Disorder

a. recurrent vs single episode

b. bereavement

2. Dysthymic Disorder

3. Bipolar I Disorder (BP I)

4. BP II Disorder

5. Cyclothymic Disorder

6. Mood disorder NOS

7. Mood Disorder due to GMC

8. Mood Disorder that is substance induced

C. Other terminology

1. unipolar disorder

2. manic depression

3. double depression

D. Specifiers for mood disorder severity, type, & course

a. severity

1. mild

2. moderate

3. severe

without psychotic features

with psychotic features

mood congruent

mood incongruent

b. type

1. chronic

2. catatonic

3. melancholic

4. atypical

5. postpartum onset

different from “postpartum blues” that is normal reaction to giving 50-80% women

c. course

1. seasonal pattern

Seasonal Affective Disorder (SAD) is not actual DSM dx

2. rapid cycling

E. Etiology

1. Psychological

a. Cognitive explanations

• Schema

Learned helplessness: lack of control over outcomes

Learned hopelessness: helplessness over outcomes + negative life events

• Cognitive triad

Self

World

Future

• Automatic thoughts

• Attributional style

negative outcomes: internal, stable, & global

positive outcomes: external, unstable, specific

• Hypothesis testing

b. Behavioral explanations

• Low rewards and associated drop in operants (i.e., behaviors) to obtain rewards

c. Interpersonal explanations

• Interpersonal loss

• Interpersonal deficits

• Interpersonal role transition

• Interpersonal role dispute

2. Sociocultural

• Gender differences (slide re: epidemiology)

Poverty

Socialized sex role expectations

3. Biological

a. genetic vulnerability (slide re: epidemiology)

• Family studies

• Twin studies

b. neurotransmitters

• 5HT

• NE

• DA

c. endocrine system

• Elevated cortisol

50% pts do not show suppression for

dexamethasone suppression test (DST)

F. Treatment of mood disorders

a. psychological

• Behavioral

• Cognitive

• Interpersonal

b. biological

• Antidepressants

• ECT

• TMS

c. special considerations for BPD

Li and anti-seizure (mood stabilizer) medications

G. Suicide predictors

• Hopelessness

• Gender

• Ideation

• Plan

Time

Place

Method

• Precautions to avoid discovery

• Personal or family history of attempt

• Substance use involved

H. Crisis Situations

• Assess risk factors

• Introduce hope for future

• Help generate alternative solutions to the problem(s)

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